The Erector Spinae Plane (ESP) block or spinal erector block was first described in September 2016 by a Canadian team. It's a block that was initially used for the treatment of chronic thoracic neuropathic pain. The ESP block is one of the inter-fascicular blocks and it's an easy-to-perform technique.In the literature, it has been reported that Lumbar ESPB provides effective analgesia after a hip surgery.
The purpose of this prospective randomized study was to compare the analgesic effects of the ultrasound-guided lumbar Erector Spinae Plane block on postoperative pain management versus the multimodal analgesia after total hip arthroplasty.
primary total hip arthroplasty with lateral approach and under general anesthesia .
• Contraindication or refusal to regional anesthesia
Contraindication to non-steroidal anti-inflammatory (NSAID's)
Allergy to opioids
Allergy to paracetamol
Sequential
Lumbal Erector Spinae Plane Block
Procedure/SurgeryLumbar ESP block performed after anesthesia induction. A low-frequency ultrasound probe will be placed longitudinally 2-3 cm lateral to the L4 transverse process. Erector spinae muscle will be visualized on the hyperechoic transverse process. The block needle (100 mm, 22G) will be inserted cranio-caudal direction and following confirmation of the correct position of the needle, between the erectorspinae muscle and the transverse process,30 ml of local anesthetic (0.25% bupivacaine/0.2% ropivacaine) will be administered for the block.
intravenous pain killers
Procedure/Surgeryintravenous pain killers
morphine consumption
total morphine dose
pain scores
numerical pain rating scale \[1 to 10 worse outcome\]
intraoperative opioid consumption
total fentanyl dose
pain on sitting position
numerical pain rating scale \[1 to 10 worse outcome\]
QR 9 score
quality of recovery score \[0 to 18 best outcome\]
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